title: Cognitive function predicts 24-month weight loss success after bariatric surgery.
abstract: BACKGROUND
  Clinically significant cognitive impairment, particularly in attention/executive and memory function, is found in many patients undergoing bariatric surgery. These difficulties have previously been linked to decreased weight loss 12 months after surgery, but more protracted examination of this relationship has not yet been conducted. The present study prospectively examined the independent contribution of cognitive function to weight loss 24 months after bariatric surgery. Given the rapid rate of cognitive improvement observed after surgery, postoperative cognitive function (i.e., cognition 12 weeks after surgery, controlling for baseline cognition) was expected to predict lower body mass index (BMI) and higher percent total weight loss (%WL) at 24-month follow-up.
  
  
  METHODS
  Data were collected by 3 sites of the Longitudinal Assessment of Bariatric Surgery (LABS) parent project. Fifty-seven individuals enrolled in the LABS project who were undergoing bariatric surgery completed cognitive evaluation at baseline, 12 weeks, and 24 months. BMI and %WL were calculated for 24-month postoperative follow-up.
  
  
  RESULTS
  Better cognitive function 12 weeks after surgery predicted higher %WL and lower BMI at 24 months, and specific domains of attention/executive and memory function were robustly related to decreased BMI and greater %WL at 24 months.
  
  
  CONCLUSIONS
  Results show that cognitive performance shortly after bariatric surgery predicts greater long-term %WL and lower BMI 24 months after bariatric surgery. Further work is needed to clarify the degree to which this relationship is mediated by adherence to postoperative guidelines.
authors.affiliation: Kent State University, Kent, Ohio; Summa Health System, Akron, Ohio. Electronic address: mspitzna@kent.edu.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Spitznagel
authors.forename: Michael
authors.initials: M
authors.lastname: Alosco
authors.forename: Gladys
authors.initials: G
authors.lastname: Strain
authors.forename: Michael
authors.initials: M
authors.lastname: Devlin
authors.forename: Ronald
authors.initials: R
authors.lastname: Cohen
authors.forename: Robert
authors.initials: R
authors.lastname: Paul
authors.forename: Ross D
authors.initials: RD
authors.lastname: Crosby
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D015992:Body Mass Index; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*
keywords: Adherence; Cognition; Executive function; Memory